Rosiglitazone and Myocardial Infarction in Patients Previously Prescribed Metformin 英文参考文献.docVIP

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Rosiglitazone and Myocardial Infarction in Patients Previously Prescribed Metformin 英文参考文献.doc

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Rosiglitazone and Myocardial Infarction in Patients Previously Prescribed Metformin 英文参考文献

RosiglitazoneandMyocardialInfarctioninPatients PreviouslyPrescribedMetformin ColinR.Dormuth1,2*,MalcolmMaclure3,4,GregCarney1,SebastianSchneeweiss5,6,KenBassett1,2 , JamesM.Wright1,2,7 1TherapeuticsInitiative,UniversityofBritishColumbia,Vancouver,Canada,2DepartmentofAnesthesiology,PharmacologyandTherapeutics,TheUniversityofBritish Columbia. Vancouver, Canada, 3School of Health Information Science, University of Victoria, Victoria, Canada, 4Pharmaceutical Services Division, British Columbia Ministry of Health, Victoria, Canada, 5Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts,UnitedStatesofAmerica,6DepartmentofEpidemiology,HarvardSchoolofPublicHealth,Boston,Massachusetts,UnitedStatesofAmerica,7Department ofMedicine,UniversityofBritishColumbia,Vancouver,Canada Abstract Objective: Rosiglitazone was found associated with approximately a 43% increase in risk of acute myocardial infarction (AMI)inatwometa-analysesofclinicaltrials.Ourobjectiveistoestimatethemagnitudeoftheassociationinreal-world patientspreviouslytreatedwithmetformin. ResearchDesignandMethods:WeconductedanestedcasecontrolstudyinBritishColumbiausinghealthcaredatabases on4.3millionpeople.Ourcohortconsistedof158,578patientswithType2diabeteswhousedmetforminasfirst-linedrug treatment. We matched 2,244 cases of myocardial infarction (AMI) with up to 4 controls. Conditional logistic regression modelswereusedtoestimatematchedoddsratiosforAMIassociatedwithtreatmentwithrosiglitazone,pioglitazoneand sulfonylureas. Results: In our cohort of prior metformin users, adding rosiglitazone for up to 6 months was not associated with an increasedriskofAMIcomparedtoaddingasulfonylurea(oddsratio[OR]1.38;95%confidenceinterval[CI],0.91–2.10),or comparedtoaddingpioglitazone(ORforrosiversuspio1.41;95%CI,0.74–2.66).Therewerealsonosignificantdifferences betweenrosiglitazone,pioglitazoneandsulfonylureasforlongerdurationsoftreatment.Thoughnotsignificantl